Level of tumor necrosis factor production by stimulated blood mononuclear cells can be used to predict response of patients with inflammatory bowel diseases to infliximab
Clinical Gastroenterology and Hepatology — Jessen B, Rodriguez-Sillke Y, Sonnenberg E, et al. | June 04, 2020
This study was sought to assess if production of tumor necrosis factor (TNF) by peripheral blood mononuclear cells (PBMCs) can be applied as a marker to predict response. Researchers performed a prospective study of 41 adults with inflammatory bowel disease (IBD) (mean age, 38 years; 21 male; 21 with Crohn’s disease and 20 with ulcerative colitis) not treated with a biologic agent within the past 6 months; patients were given their first infusion of infliximab at a hospital or clinic in Berlin, Germany. They obtained data on clinical scores, levels of C-reactive protein, and ultrasound results (Limberg scores) at baseline (before the first infusion) and after 6 weeks (3rd infliximab infusion). Production of cytokines (TNF, interleukin 1 [IL1], IL6, IL8, IL10, IL12p70, and IL22) were assessed by ELISA and performed cytometric bead array and flow cytometry analyses. This study's findings demonstrate that production of a high level of TNF by PBMCs (specifically CD14+ cells) from patients with IBD can distinguish those most likely to have a clinical response to infliximab therapy. A cutoff value of 500 pg/ml TNF distinguished responders with 100% sensitivity and 82% specificity in patients with Crohn’s disease.